술후 재발된 위암환자에서 발생한 악성 문합부 협착에 대한 피복형 팽창성 금속 스텐트 설치술 = Covered Self-Expandable Metallic Stent Placement for a Post-operative Malignant Anastomotic Stricture Secondary to Recurrent Gastric Cancer

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate the technical feasibility and clinical effectiveness of stent placement for the treatment of a post-operative malignant anastomotic stricture secondary to recurrent gastric cancer.
Materials and Methods: Under fluoroscopic guidance, one or two covered stents were placed in 20 consecutive patients (age range, 44-75 years) with an anastomotic stricture due to a recurrent gastric malignancy. Before stent placement, all patients had severe nausea and recurrent vomiting after ingestion.
Results: Stent placement was technically successful for all patients, and no procedural complications occurred. After stent placement, 18 of 20 (90.0%) patients were able to ingest at least a liquid diet and had a markedly decreased incidence of vomiting. During the follow-up of 2-116 weeks (mean, 25.5 weeks), stent migration occurred in two patients (10.0%) on one day after the procedure. All patients with stent migration were treated successfully by means of placing a second stent. Three patients showed a recurrence of the stricture due to tumor overgrowth; two of the patients were treated with coaxial placement of a second stent. Another patient refused additional management.
Conclusion: Covered self-expandable metallic stent placement seems to be technically feasible and effective for palliative treatment of a post-operative malignant anastomotic stricture secondary to recurrent gastric cancer.

국문 초록 (Abstract)

목적: 수술 후 재발한 위암환자의 악성 문합부 협착에 대한 피복형 팽창성 금속 스텐트 설치술의 용이성과 치료 효과를 알아보았다.
대상과 방법: 위암 재발에 의해 문합부 협착이 발생한 20명(연령 범위, 44-75세)의 환자에 대해 투시 하에서 피복형 팽창성 금속 스텐트 1개 또는 2개를 삽입하였다. 모든 환자는 스텐트 설치술 전 심한 오심과 반복되는 식후 구토의 증상을 호소하였다.
결과: 모든 환자에서 성공적으로 스텐트를 설치하였으며 시술과 관련된 합병증은 없었다. 스텐트 설치 후 20명 중 18명(90.0%)은 최소한 유동식 정도의 음식물 섭취가 가능하였다. 2-116주(평균, 25.5주)간의 추적관찰 기간 중 2명의 환자에서 시술 1일 후 스텐트 전위가 발생하였고 모두 추가적 스텐트 삽입으로 증상이 호전되었으며, 3명의 환자에서 종양성장에 의한 재협착이 있었고 추가적인 치료를 거부한 1명을 제외한 2명은 추가적인 스텐트 삽입으로 치료하였다.
결론: 수술 후 재발한 위암환자의 악성 문합부 협착에 대한 고식적 치료로써 피복형 팽창성 금속 스텐트 설치술은 시술이 비교적 쉬우며 효과적인 치료방법으로 생각된다.

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